血清胰岛素水平与甲状腺腺瘤术后并发甲状腺危象的相关性  

Correlation between the levels of serum insulin and thyroid crisis after subtotal thyroidectomy

作　　者：郭宁[1] 高文[1] 李彩霞[1] 

机构地区：[1]天津市第四中心医院两腺科,天津300000

出　　处：《中国生化药物杂志》2016年第10期149-151,共3页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探讨血清胰岛素水平与甲状腺腺瘤术后并发甲状腺危象的相关性及其预测价值。方法酶联免疫吸附试验法检测318例甲状腺腺瘤患者及30例健康志愿者（对照组）空腹血清胰岛素水平,分析术前血清胰岛素水平、年龄、性别与甲状腺腺瘤术后并发甲状腺危象患者的相关性,Logistic回归多因素分析预测甲状腺腺瘤术后并发甲状腺危象的发病因素。结果 318例甲状腺瘤术后并发甲状腺危象26例（8.18%）。并发甲状腺危象组例数在血清胰岛素水平≤7.4 m U/L显著低于未并发甲状腺危象组及对照组（P〈0.05）,而随着血清胰岛素水平的升高,并发甲状腺危象组患者在9.5-12.1 m U/L内的例数显著高于未并发甲状腺危象组及对照组,差异有统计学意义（P〈0.05）。ROC曲线显示,并发甲状腺危象组最佳预测值为11.9 m U/L。血清胰岛素水平在9.5-12.1 m U/L内敏感度、特异度均较高,分别为71.17%、98.76%,具有一定程度的预测作用。Logistic回归多因素分析结果显示,血清胰岛素水平（OR=2.083,P〈0.05）,女性（OR=1.921,P〈0.05）,年龄≥43.0岁（OR=1.982,P〈0.05）均与甲状腺瘤术后并发甲状腺危象呈正相关。结论随着血清胰岛素浓度的增高,甲状腺腺瘤患者术后并发甲状腺危象的几率升高,血清胰岛素水平、年龄≥43.0岁、女性均可能是预测甲状腺腺瘤患者术后并发甲状腺危象的指标。Objective To value the relationship and prediction of serum insulin and thyroid crisis after subtotal thyroidectomy. Methods The enzyme linked immunosorbent assay was used to determine 318 patients with thyroid adenoma and 30 cases of healthy volunteers（ control group） and fasting serum insulin levels,the correalation of preoperative serum insulin level,age,gender and thyroid crisis were analzed in patients with thyroid adenoma after operation. The risk factors related to thyroid crisis after subtotal thyroidectomy were measured by Logistic regression. Results There were26 cases（ 8. 18%） patients with thyroid crisis after subtotal thyroidectomy of all 318 cases. The cases in thyroid crisis group of insulin levels≤7. 4 m U /L was significantly lower than non-thyroid crisis group and control group（ P〈0. 05）,with the increasing of insulin levels,the cases in thyroid crisis group of 9. 5-12. 1 m U / L was higher than non-thyroid crisis group and control group（ P〈0. 05）,there was significant difference（ P〈0. 05）. The ROC showed that the best predictor was 11. 9 m U / L in thyroid crisis group. The sensitivity of 71. 17% and specificity of 98. 76% was higher at serum insulin levels of 9. 5-12. 1 m U / L. The Logistic result showed that there was a positive correlation between serum insulin level（ OR = 2. 083,P〈0. 05）,woman（ OR = 1. 921,P〈0. 05）,older than 43. 0 years（ OR = 1. 982,P〈0. 05） and thyroid crisis. Conclusion With the increasing of serum insulin concentration,increasing probability of thyroid crisis occurred in patients with thyroid adenoma,serum insulin concentration,older than 43. 0 years,woman are likely to be risk factors related to thyroid crisis prediction.

关 键 词：血清胰岛素 甲状腺瘤 甲状腺危象 相关性 

分 类 号：R736.1[医药卫生—肿瘤]